HomeMy WebLinkAbout2004-P07762 - attached deck PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P07762
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 8/10/2004
SITE ADDRESS: 801 Tonkawa Rd
Long Lake,MN 55356
PID: 08-117-23-21-0001
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Construction Type VN
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 293.25 Valuation: $ 18,000.00
Plan Review Fee: $ 190.58
State Surcharge Fee: $ 9.50
TOTAL FEE: $ 493.33
APPLICANT: Rightway General Contractor,Inc. OWNER: David&JoAnn Pomije
42383 250th Street 801 Tonkawa Rd
Arlington,MN 55307 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
APPLI PERMIT SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Siznitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessine. 1-Finance Page 1
` yk U�ycrn �
Total Fee: $ 4q 3. 33Sa �5 Date Received: 7-A'0`f
Entered By: Permit#:
CITY OF ORONO - BUI DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNERCONTRACTOR
JOB SITE ADDRESS: �'�! T/I�K�f�4 ,�� /✓� /V ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes No If yes, a special event permit is required with Police Department and City
Council approval 60 days prior to the event. Non permitted events will not
be allowed.
NAME OF OWNER: 12Aayl,7 PHONE: (home) 4171`1916`7
(work)
MAILING ADDRESS: 149 CITY: 4149*0 ZIP:
CONTRACTOR: A14#17V,�,5P1�-e?✓4WC, 6�*)PPfWeMe**PHONE:
CONTACT PERSON: -0161V 3�e V1A74 MOBILE/PAGER: 3�-
MAILING ADDRESS: -Y X98.3 0,5-0 ST CITY: '1!;�/✓wT�iy' ZIP: _-7
STATE LICENSE: #
ARCHITECT/ENGINEER: 1tA1Ji5n1 PHONE:
MAILING ADDRESS: k/1,0 6�v,;;'- cy, e- 4-4e CITY: �i�✓N�rL41e4 ZIP: '5 53
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure x.
Addition Move
Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): iGValz-�
�ltiTlyi✓ GoNy�rn'G-
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ IRIVOO -e0
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATU DATE:
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth imt6ig section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be
informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision;oir statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or Property tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may
require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the
date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within
that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local,state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
�'T�'lI cT9n1�S
First Middle
Last
Address
City State Zip Phone
I under tand my rights as stated above.
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: eV( T-ON(CAW IA
PID:
DESCRIPTION OF WORK: -t•1=
-------------------------------------------------7 _Gy---
ZONING REVIEW BY: DATE APPROVED. - 2 S
BUILDING REVIEW BY: DATE APPROVED:
—
FEES TO BE CHARGED:— Misc. Fees Calculated By: —
PERMIT Yes f No
PLAIN REVIEW Yes ,/ No SEWER CONNECTION
STATE SURCHARGE Yes -� No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC-Units OTHER (specify)
--______-------------_—__----___ ------------ --------------------------------------------------
ZONING CHECKLIST ZoningaDistrict: G(Z.-)--
Fire Department: Post Office: School District:
Lot Area: Sq.ft. 1 S Stl-12.y Acres 3 Width Depth
Survey Submitted: Yes X_ No Date of Survey: &
Proposed Setbacks:
Fi4at(Lake): 3 9 Right Side: i a 2 }
Rear(Street): 3t5" Left Side: 2 4!;
Adjacent Structures: A T'a Ac.1hfQ Wetland: N JA
Building Height: Def. Hgt. — Peak Hat.
Lot Coverage:
Grading: Staff Approval Date: /V /r0 By: Council Approval Date:
Septic: Staff Approval Date: /V(A By:
Zoning File: #of-Jo2b Resolution: # Resolutioa Date: 7-z 6 -e'f
Shoreland District: _T5
Avg. Setback: V
tU Bluff Setback: Lot Coverage: /y//9
Existing Proposed
Hardcover: 0-75' 3•z
75-250' r '
250-500' 27_4
500-1000'
Hardcover Variance Required: Yes_)I No Date of Council Approval: 1- Z�-O�1
REMARKS(in house):
7
BUILDING REVIEW CHECK LIST
UBC: t2. 3 CONSTRUCTION TYPE: V�
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x _
2nd Floor x —
Garage x =
x =
TOTAL
Estimated Construction Value: $ ( ;�•ppp°b '
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
.14 Footing - Septic Sewer Connection
_ Framing Fireplace Lawn Irrigation
Insulation (Masomy) Other
Wall Board (Mfg.) Well (State Permit)
—o Final Grading/Filling Electrical (State Permit)
Other
RENLA.RKS(IN HOUSE):
----------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
---------------------------------------------------------------------
REMA.RKS (TO BE NOTED ON PERiNni):
8
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BUILDING P MIT AN REVIEW
!
INSPECTOR
' DATE FERti11T NO._______--
Cl APPROVED AS SUF-.%!T i ED
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with ^!I �c,^•i.:::_l:L hu'.idin; and tonin cod9.
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KEEP THIS PLAN SET ON 81t AT ALL 119
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DATE
TIME
CITY OF ORONO t/ CALLED IN 9//jam-/'
INSPECTION NOTICE SCHEDULED 'SI1{�/ cpem
PERMIT NO. P '7 402- COMPLETED
ADDRESS Kb] 70Y)e- A 1 112
OWNER CONTR. r
TELEPHONE NO. LOl�- " VO/'
DESCRIPTION
01 FOOTING 11 MECHANICAL RI EXCAWGRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL �\ /J 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES NO
COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contracto
Inspector.
White CopylInspector's File Canary Copy/Site Notice
L�k
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICL-1'7�1-' SCHEDULED
PERMIT NO. COMPLETED
ADDRESS r-a'`-`j
OWNER CONTR.
TELEPHONE NO. a :3
DESCRIPTION i:7r)o z/
01 FOOTING 11 MECHANICAL RI 18 EXCAV GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 IAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Lul 09 PLUMBING RI 23SEPTI FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTORTOMEET YOU: YES_NO
COMMENTS:
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W
CC
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cc
LJ X
UORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
WORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (952) 249-4600
Owner/Contr r site:
Inspector.
White Copyllnspectoes Fil Canary Copy/Site Notice
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